Virginia Henderson

Virginia Henderson's Need Theory

This page was last updated on March 1, 2011

“Nursing theories mirror different realities, throughout

their development; they reflected the interests of

nurses of that time.”

I n t r o d u c t i o n

“The Nightingale of Modern Nursing”

“Modern-Day Mother of Nursing.”

"The 20th century Florence Nightingale."

Born in Kansas City, Missouri, in 1897.

Received a Diploma in Nursing from the Army

School of Nursing at Walter Reed Hospital,

Washington, D.C. in 1921.

Worked at the Henry Street Visiting Nurse

Service for 2 years after graduation.

In 1923, started teaching nursing at the Norfolk

Protestant Hospital in Virginia

In 1929, entered Teachers College at Columbia

University for Bachelor’s Degree in 1932,

Master’s Degree in 1934.

Joined Columbia as a member of the faculty,

remained until 1948.

Since 1953, a research associate at Yale

University School of Nursing.

recipient of numerous recognitions.

Her work influenced the nursing profession

throughout the world.

a well known nursing educator and a prolific

author.

honorary doctoral degrees from the Catholic

University of America, Pace University,

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University of Rochester, University of Western

Ontario, Yale University

In 1985, honored at the Annual Meeting of the

Nursing and Allied Health Section of the Medical

Library Association.

Died: March 19, 1996.

In 1939, she revised: Harmer’s classic textbook

of nursing for its 4th edition, and later wrote the

5th; edition, incorporating her personal

definition of nursing (Henderson,1991)

School of thoughts in Nursing Theories-1950-1970

Need theorists Interaction Theorists

Outcome theorists

Abdellah

Henderson

Orem

King

Orlando

Peterson and Zderad

Paplau

Travelbee

Wiedenbach

Johnson

Levine

Rogers

Roy

Analysis of nursing theories according to 1st School

Focus Problems

Human beingA set of needs or problems.

A developmental being.Patient Need DeficitOrientation Illness, diseaseRole of nurse Dependent on medical practice.

Beginnings of independent functions

Nursing Research

Quiz-VIII

Nursing Management

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Nursing Management

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Nursing Education

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Introduction to

Nursing Theories

Development of

Nursing Theories

Virginia Henderson’s

Need Theory

Theory if

Interpersonal

Relations

Faye Glenn Abdellah's

Theory

Jean Watson's theory

Johnson’s behavior

system model

Theory of Goal

Attainment

Betty Neuman’s

system model

Levin's Four

Conservation

Principles

Nursing Theorists

Fulfill needs requisitesDecision making Primarily health care professional

Henderson’s Theory Background

Henderson’s concept of nursing was derived

form her practice and education therefore, her

work is inductive..

She called her definition of nursing her

“concept” (Henderson1991)

She emphasized the importance of increasing

the patient’s independence so that progress

after hospitalization would not be delayed

(Henderson,1991)

Virginia Henderson defined nursing as "assisting

individuals to gain independence in relation to

the performance of activities contributing to

health or its recovery" (Henderson, 1966).

She categorized nursing activities into 14

components, based on human needs.

She described the nurse's role as substitutive

(doing for the person), supplementary (helping

the person), complementary (working with the

person), with the goal of helping the person

become as independent as possible.

Her definition of nursing was one of the first

statements clearly delineating nursing from

medicine:

"The unique function of the nurse is to assist the

individual, sick or well, in the performance of those

activities contributing to health or its recovery (or to

peaceful death) that he would perform unaided if he

had the necessary strength, will or knowledge. And to

do this in such a way as to help him gain independence

Martha Roger’s

Science of unitary

human beings

Theories Based on

Interactive Process

Orem's Self-Care

Deficit Theory

Nursing Theories: An

Overview

Nursing Theories and

Research

Roy's Adaptation

Model

Orlando's Nursing

Process

Notes on Nursing:

What it is, What it is

not: Nightingale

Understanding the

works of Nursing

Theorists: A creative

beginning

Health Promotion

Model

Health Belief Model

Theories used in

Community Health

Nursing

Application of Nursing

Theories

Application Goal

as rapidly as possible" (Henderson, 1966).

The 14 components

Breathe normally. Eat and drink adequately.

Eliminate body wastes.

Move and maintain desirable postures.

Sleep and rest.

Select suitable clothes-dress and undress.

Maintain body temperature within normal range

by adjusting clothing and modifying environment

Keep the body clean and well groomed and

protect the integument

Avoid dangers in the environment and avoid

injuring others.

Communicate with others in expressing

emotions, needs, fears, or opinions.

Worship according to one’s faith.

Work in such a way that there is a sense of

accomplishment.

Play or participate in various forms of recreation.

Learn, discover, or satisfy the curiosity that leads

to normal development and health and use the

available health facilities.

The first 9 components are physiological. The tenth and

fourteenth are psychological aspects of communicating

and learning The eleventh component is spiritual and

moral The twelfth and thirteenth components are

sociologically oriented to occupation and recreation

Assumption

The major assumptions of the theory are:

Attainment Theory

Application Orem's

Self-care Deficit

Theory

Application of

Suchman’s Stages of

Illness Model

Application of Betty

Neuman's Systems

Model in Nursing Care

Application of Roy's

Adaptation Model in

Nursing Process

Application of

Peplau's Interpersonal

theory in Nursing

Process

Application of Health

Belief Model in

Nursing Practice

Transcultural Nursing

Helping and Human

Relationships Theory:

Robert R. Carkhuff

Models of Prevention

Care, Cure and Core:

The Three C’s of Lydia

Hall

Human Becoming

Theory:Rosemarie

Rizzo Parse

"Nurses care for patients until patient can care

for themselves once again. Patients desire to

return to health, but this assumption is not

explicitly stated.

Nurses are willing to serve and that “nurses will

devote themselves to the patient day and night”

A final assumption is that nurses should be

educated at the university level in both arts and

sciences.

Henderson’s theory and the four major concepts

1. Individual

Have basic needs that are component of health.

Requiring assistance to achieve health and

independence or a peaceful death.

Mind and body are inseparable and interrelated.

Considers the biological, psychological,

sociological, and spiritual components.

The theory presents the patient as a sum of parts

with biopsychosocial needs, and the patient is

neither client nor consumer.

2. Environment

Settings in which an individual learns unique

pattern for living.

All external conditions and influences that affect

life and development.

Individuals in relation to families

Minimally discusses the impact of the

community on the individual and family.

Supports tasks of private and public agencies

Society wants and expects nurses to act for

From Novice to

Expert: Patricia

Benner

Erikson's Theory of

Psychosocial

Development

Theory of Cognitive

Dissonance by Leon

Festinger

Kurt Lewin's Change

Theory

Prochaska and

DiClemente's Stages

of Change Model

Ernestine

Wiedenbach's "The

Helping Art of Clinical

Nursing"

A directory of open

access nursing theory

articles

Maslow's Theory of

Needs

Models of Nursing

Care Delivery

Theories of Florence

Nightingale

Human-To-Human

Relationship Model by

Joyce Travelbee(1926-

1973)

individuals who are unable to function

independently. In return she expects society to

contribute to nursing education.

Basic nursing care involves providing conditions

under which the patient can perform the 14

activities unaided

3. Health

Definition based on individual’s ability to

function independently as outlined in the 14

components.

Nurses need to stress promotion of health and

prevention and cure of disease.

Good health is a challenge. Affected by age,

cultural background, physical, and intellectual

capacities, and emotional balance Is the

individual’s ability to meet these needs

independently?

4. Nursing

Temporarily assisting an individual who lacks the

necessary strength, will and knowledge to satisfy

1 or more of 14 basic needs.

Assists and supports the individual in life

activities and the attainment of independence.

Nurse serves to make patient “complete”

“whole", or "independent."

Henderson's classic definition of nursing:

"I say that the nurse does for others what they

would do for themselves if they had the strength,

the will, and the knowledge. But I go on to say

that the nurse makes the patient independent of

him or her as soon as possible."

Newman's Health As

Expanding

Consciousness

Comfort Theory by

Katharine Kolcaba

Tidal Model of Mental

Health Nursing New!

The Trajectory Model

by Corbin & Strauss

Modeling and Role

Modeling Theory by

Erickson, Tomlin &

Swain

Life Perspective

Rhythm Model by

Joyce Fitzpatrick

Functional Health

Patterns by Majory

Gorden

McGill Model of

Nursing by F. Moyra

Allen

The nurse is expected to carry out

physician’s therapeutic plan Individualized care

is the result of the nurse’s creativity in planning

for care.

Use nursing research

o Categorized Nursing : nursing care

o Non nursing: ordering supplies,

cleanliness and serving food.

In the Nature of Nursing “ that the nurse is and

should be legally, an independent practitioner

and able to make independent judgments as

long as s/he is not diagnosing, prescribing

treatment for disease, or making a prognosis, for

these are the physicians function.”

“Nurse should have knowledge to practice

individualized and human care and should be a

scientific problem solver.”

In the Nature of Nursing Nurse role is,” to get

inside the patient’s skin and supplement his

strength will or knowledge according to his

needs.”

And nurse has responsibility to assess the needs

of the individual patient, help individual meet

their health need, and or provide an

environment in which the individual can perform

activity unaided

Henderson's classic definition of nursing "I say

that the nurse does for others what they would

do for themselves if they had the strength, the

will, and the knowledge.

But I go on to say that the nurse makes the

patient independent of him or her as soon as

possible."

H e n d e r s o n ’ s a n d N u r s i n g P r o c e s s

”Summarization of the stages of the nursing process as

applied to Henderson’s definition of nursing and to the

14 components of basic nursing care.

Nursing Process Henderson’s 14 components and

definition of nursing

Nursing

Assessment

Henderson’s 14 components

Nursing Diagnosis Analysis: Compare data to knowledge

base of health and disease.

Nursing plan Identify individual’s ability to meet

own needs with or without

assistance, taking into consideration

strength, will or knowledge.

Nursing

implementation

Document how the nurse can assist

the individual, sick or well.

Nursing

implementation

Assist the sick or well individual in to

performance of activities in meeting

human needs to maintain health,

recover from illness, or to aid in

peaceful death.

Nursing process Implementation based on the

physiological principles, age, cultural

background, emotional balance, and

physical and intellectual capacities.

Carry out treatment prescribed by

the physician.

Nursing

evaluation

Henderson’s 14 components and

definition of nursing

Use the acceptable definition

of ;nursing and appropriate laws

related to the practice of nursing.

The quality of care is drastically

affected by the preparation and

native ability of the nursing

personnel rather that the amount of

hours of care.

Successful outcomes of nursing care

are based on the speed with which or

degree to which the patient performs

independently the activities of daily

living

Comparison with Maslow's Hierarchy of Need

Maslow's Henderson

Physiological needs

Breathe normally

Eat and drink adequately Eliminate by all avenues of elimination Move

and maintain desirable posture Sleep and rest Select suitable clothing

Maintain body temperature Keep body clean and well groomed and

protect the integument

Safety Needs Avoid environmental dangers and avoid injuring other

Belongingness and love needs

Communicate with others

worship according to one's faithEsteem needs Work at something providing a sense

of accomplishment

Play or participate in various forms of

recreation

Learn, discover, or satisfy curiosity

Characteristic of Henderson’s theory

There is interrelation of concepts in such a way

as to create a different way of looking at a

particular phenomenon.

Concepts of fundamental human needs,

biophysiology, culture, and interaction,

communication are borrowed from other

discipline.Eg.. Maslow’s Hierarchy of human

needs; concept of interaction-communication

i.e. nurse-patient relationship

Her definition and components are logical and

the 14 components are a guide for the individual

and nurse in reaching the chosen goal.

Theories should be relatively simple yet

generalizable.

Her work can be applied to the health of

individuals of all ages.

Theories can be the bases for hypotheses that

can be tested. Her definition of nursing cannot

be viewed as theory; therefore, it is impossible

to generate testable hypotheses.

However some questions to investigate the

definition of nursing and the 14 components

may be useful.

Theories contribute to and assist in increasing

the general body of knowledge within the

discipline through the research implemented to

validate them.

Her ideas of nursing practice are well accepted

throughout the world as a basis for nursing care.

However, the impact of the definition and

components has not been established through

research.

Theories can be utilized by practitioners to guide

and improve their practice.

Ideally the nurse would improve nursing practice

by using her definition and 14 components to

improve the health of individuals and thus

reduce illness.

Usefulness

Nursing education has been deeply affected by

Henderson’s clear vision of the functions of

nurses.

The principles of Henderson’s theory were

published in the major nursing textbooks used

from the 1930s through the 1960s, and the

principles embodied by the 14 activities are still

important in evaluating nursing care in thee21st

centaury.

Others concepts that Henderson (1966)

proposed have been used in nursing education

from the 1930s until the present O'Malley, 1996)

Limitations

Lack of conceptual linkage between physiological

and other human characteristics.

No concept of the holistic nature of human

being.

If the assumption is made that the 14

components prioritized, the relationship among

the components is unclear.

Lacks inter-relate of factors and the influence of

nursing care.

Assisting the individual in the dying process she

contends that the nurse helps, but there is little

explanation of what the nurse does.

“Peaceful death” is curious and significant

nursing role.

PURPOSES OF NURSING THEORIES

In Practice:

Assist nurses to describe, explain, and predict

everyday experiences.

Serve to guide assessment, interventions, and

evaluation of nursing care.

Provide a rationale for collecting reliable and

valid data about the health status of clients,

which are essential for effective decision making

and implementation.

Help to describe criteria to measure the quality

of nursing care.

Help build a common nursing terminology to use

in communicating with other health

professionals.

Ideas are developed and words are defined.

Enhance autonomy (independence and self-

governance) of nursing through defining its own

independent functions.

In Education:

Provide a general focus for curriculum design

Guide curricular decision making.

In Research:

Offer a framework for generating knowledge and

new ideas.

Assist in discovering knowledge gaps in the

specific field of study.

Offer a systematic approach to identify questions

for study; select variables, interpret findings, and

validate nursing interventions.

Approaches to developing nursing theory

Borrowing conceptual frameworks from other

disciplines.

Inductively looking at nursing practice to

discover theories/concepts to

explain phenomena.

Deductively looking for the compatibility of a

general nursing theory with nursing practice.

Questions from practicing Nurse about using

Nursing theory

Practice

Does this theory reflect nursing practice as I

know it?

Will it support what I believe to be excellent

nursing practice?

Can this theory be considered in relation to a

wide range of nursing situation?

Personal Interests, Abilities and Experiences

What will it be like to think about nursing theory

in nursing practice?

Will my work with nursing theory be worth the

effort?

Conclusion

Henderson provides the essence of what she

believes is a definition of nursing.

She didn’t intend to develop a theory of nursing

but rather she attempted to define the unique

focus of nursing.

Her emphasis on basic human needs as the

central focus of nursing practice has led to

further theory development regarding the needs

of the person and how nursing can assist in

meeting those needs.

Her definition of nursing and the 14 components

of basic nursing care are uncomplicated and self-

explanatory.

References

1. Timber BK. Fundamental skills and concepts in

Patient Care, 7th edition, LWW, N

2. George B. Julia , Nursing Theories- The base for

professional Nursing Practice , 3rd ed. Norwalk,

Appleton & Lange.

3. Wills M.Evelyn, McEwen Melanie (2002).

Theoretical Basis for Nursing Philadelphia.

Lippincott Williams& wilkins.

4. Meleis Ibrahim Afaf (1997) , Theoretical Nursing :

Development & Progress 3rd ed.

Philadelphia, Lippincott.

5. Taylor Carol,Lillis Carol (2001)The Art &

Science Of Nursing Care 4th ed.

Philadelphia, Lippincott.

6. Potter A Patricia, Perry G Anne (1992)

Fundamentals Of Nursing –Concepts Process &

Practice 3rd ed. London Mosby Year Book.

7. Vandemark L.M. Awareness of self & expanding

consciousness: using Nursing theories to prepare

nurse –therapists Ment Health Nurs. 2006 Jul;

27(6) : 605-15

8. Reed PG, The force of nursing theory guided-

practice. Nurs Sci Q. 2006 Jul;19(3):225

9. Delaune SC,. Ladner PK, Fundamental of nursing,

standard and practice, 2nd edition, Thomson,

NY, 2002

http://currentnursing.com/nursing_theory/Henderson.html

Virginia Henderson (1955, 1966, 1969, 1978)

25. APR, 2010  0 COMMENTS

Person/Client: A whole, complete, and independent being

who has 14  fundamental needs to breathe, eat and drink, eliminate, move and

maintain posture, sleep and rest, dress and undress, maintain body temperature,

keep clean, avoid danger, communicate, worship, work, play and learn.

Environment: The aggregate of the external conditions and influences affecting

the life and development of an organism

Health: Viewed in terms of the individuals ability to perform 14 components of

nursing care unaided (eg, breathe normally, eat and drink adequately). Health is

quality of life basic to human functioning and requires independence and

interdependence.  It is the quality of health rather life itself that allows people to

work most effectively and to teach their highest potential level of satisfaction in

life. Individuals will achieve or maintain health if they have necessary strength,

will, or knowledge.

Nursing: The unique function of the nurse is to assist clients, sick or well, in

performing those activities contributing to health, its recovery, or peaceful death –

activities that client would perform unaided if they had the necessary strength,

will, or knowledge. Al;so, to do so in such a way as to help clients gain

independence as rapidly as possible.

Henderson’s Definition of Nursing:

In 1955, Virginia Henderson formulated a definition of the unique function of

nursing. This definition was a major stepping-stone in the emergence of nursing

as a discipline separate from medicine. Basic to her definition are various

assumptions about the individual: namely, that the individual (a) needs to

maintain physiologic and emotional balance, (b) requires assistance to achieve

health and independence or a peaceful; death, and (c) needs the necessary

strength, will, or knowledge to achieve or maintain health. These needs give

direction to the  nurse’s role.

Henderson cenceptualized the nurse’s role as assisting sick or well individuals in

a supplementary or complementary way. The nurse needs to be a partner with

the patient, a helper to the paitent, and, when necessary, a substitute for the

patient. The nurse’s focus is to thelp individuals and families (which she viewed

as a unit) to gain independence in meeting 14 fundamental needs (Henderson

1966):

1. Breathing normally.

2. Eating and drinking adequately.

3. Eliminaitng body wastes.

4. Moving and maintining a desirable position.

5. Sleeping and resting.

6. Selecting suitbale clothes.

7. maintianing body temperature within normal range by adjusting clothing and

modifying the environamnet.

8. Keeping the body clean and well-groomed to protect the integument.

9. Avoiding dangers in the environment and avoiding inhuring others.

10. Coomunicating with others in expressing emotions, needs, fears, or oipinions.

11. worshiping according to one’s faith.

12. working in such a way that one feels a sense of accomplishment.

13. Playing or participating in various forms of recreations.

14. Learning, discovering, or satisfying the curiosity that leads to normal

development and health, and using available health facilities.

Kozier, Barbara et.al  Fundamentals of Nursing. 5th edition

Addison-Wesley Publishing company, Inc. 1998. p. 47

http://www.nursingbuddy.com/2010/04/25/virginia-henderson1955196619691978/

Henderson Theory of NursingDefinition

The Henderson theory of nursing encompasses a definition of nursing, a description of the function of a nurse, and the enumeration of the 14 components that make up basic nursing care.

Description

The Henderson theory of nursing was developed by Virginia Henderson. She did not believe that she was setting out a theory, and preferred it to be thought of as a definition. Whether it is considered a definition or a theory, it has had a wide influence on concept and practice of

nursing.

Virginia Henderson was born on November 30, 1897, in Kansas City, Missouri. She began her nursing education in the U.S. Army School of Nursing during World War I, from which she

graduated in 1921. She also received a Bachelors of Science degree in 1932 and a Masters degree in 1934 from Teachers College, Columbia University. She also taught at Teacher's

College, and at the Yale School of Nursing. She died March 19, 1996, when she was 98 years old. The Sigma Theta Tau International Nursing Library is named in her honor.

The definition of nursing is the fundamental part of Henderson's theory of nursing. Henderson defined nursing as doing things for patients that they would do for themselves if they could, that is if they were physically able or had the required knowledge. Nursing helps the patient become

healthy or die peacefully, and also helps people work toward independence, so that they can begin to perform the relevant activities for themselves as quickly as possible. Rather than focus on a particular task, Henderson focused on the patient. She saw how nursing could focus on the patient, and how it was possible to focus on developing a good nurse-patient relationship. This

deeply affected her and she believed strongly that patient-focused nursing was the most beneficial kind of nursing for the patient.

Henderson also enumerated the 14 functions she believed to be part of basic nursing care. The nurse should help the patient to perform the following functions:

eat and drink breathe move sleep dress

work to gain a sense of accomplishment maintain normal body temperature

eliminate wastes keep clean

communicate participate in recreation

worship avoid dangers or hurting others

learn and discover

When the patient was able to perform all the functions by him or herself then the patient could be considered independent and no longer required the aid of a nurse.

Virginia Henderson also believed that it was important that nursing be based on evidence, and that research was a critical component of improving nursing practice. She believed all nurses should have access to literature on nursing and current nursing research to help better their

practices, and to this end, she worked to develop an index of nursing.

Viewpoints

Virginia Henderson played a very important role in the development of modern nursing. Her contributions, especially to evidence based nursing practice, are considered so important that

Sigma Theta Tau's International Nursing Library has been named in her honor.

Professional implications

The booklet that Virginia Henderson wrote outlining her definition of nursing, called "Basic Principles of Nursing Care," was published in 1960 and has since been translated into more than

20 languages. It is a widely read and widely used booklet that has had a significant impact on many nurses. Henderson believed that the nurse should help the individual achieve independence as much as possible, and that the nurse should take a patient centered approach to nursing to be

based in evidence and research. She also believed that a nurse should be considered an independent member of the total health care team, and that the nurse should only perform

nursing functions, neither performing the diagnosis, prescription, and prognosis functions of a physician or any tasks such as serving food and cleaning that were not directly related to helping

the patient with the fourteen basic nursing functions.

Resources

BOOKS

Parker, Marilyn E. Nursing Theories and Nursing Practice. Philadelphia: E.A. Davis Company, 2001.

Sitzman, Kathleen, and Lisa Wright Eichelberger. Understanding the Work of Nurse Theorists. Sudbury, MA: Jones and Bartlett Publishers, 2004.

PERIODICALS

Henderson, Virginia. "Excellence in Nursing." American Journal of Nursing 100 (October 2000): 961.

ORGANIZATIONS

American Association for the History of Nursing. PO Box 175, Lanoka Harbor, NJ 08734. (609) 693-7250.http://www.aahn.org/.

American Nurses Association. 600 Maryland Ave. SW, Ste. 100 West, Washington , DC 20024. (800) 274-4ANA.http://www.nursingworld.org.

OTHER

Nursing library. ⟨ http://www.nursinglibrary.org/Portal/Main.aspx?PageID=4002 ⟩  (February 22, 2006).

"Nursing Theory Page." USD Hahn School of Nursing 2003.http://www.sandiego.edu/nursing/theory/ (November 10, 2005).

Henderson Theory of Nursing

© Ariel Skelley/CORBIS. Reproduced by permission.